Triaditis in Cats: Symptoms, Diagnosis and Treatment

Reviewed by Dr. Fiona Lee

If your cat has diarrhea, decreased appetite, weight loss and a fever, a condition known as triaditis could be to blame.¹

Triaditis is diagnosed when your cat experiences three separate diseases—pancreatitis, cholangiohepatitis and inflammatory bowel disease—at the same time.¹ Up to 56% of cats diagnosed with pancreatitis and up to half of cats diagnosed with cholangitis (also known as inflammatory liver disease) have triaditis.²

Early diagnosis and treatment of triaditis is important. The longer cats live with undiagnosed (and untreated) triaditis, the greater the chance that complications like fatty liver syndrome or liver failure will develop.³

Understanding triaditis in cats

What is triaditis?

Triaditis means “inflammation in three specific groups" because the condition involves three organs: the pancreas, liver and small intestine. Triaditis can be caused by a combination of inflammation, immune issues and infection.¹

Common causes and risk factors

While the exact cause is unknown, cats might be prone to the condition because their bile and pancreatic ducts connect to a single opening that flows into the first section of the small intestine, called the duodenum. The duodenum contains a high number of natural bacteria, and its proximity to the liver and pancreas makes it easy for bacteria to transfer, resulting in inflammation.¹

It's also possible that an infectious or autoimmune process leads to triaditis.¹ Regardless of the cause, triaditis in cats can be acute or chronic.⁴ There is no clear link between a cat's age, sex or breed and their likelihood of developing triaditis.⁵

Why triaditis is a serious condition

The liver, pancreas and small intestine all perform essential functions. The liver produces bile that's released into the intestines to help with digestion; the pancreas also produces digestive enzymes; and digestion occurs in the small intestine, which passes the remaining waste through to the bowels.³

When these organs are inflamed at the same time, it causes your cat to feel unwell.³ Triaditis can also cause your cat to lose their appetite. Cats that go through periods of not eating are at risk for a serious, and potentially fatal, condition known as fatty liver disease.⁶

Life expectancy

When triaditis is diagnosed early and receives proper treatment, there are good odds of recovering. Left untreated, the condition can be fatal.⁴

Feline triaditis symptoms

Cats with triaditis can experience these symptoms:¹

• Vomiting
• Diarrhea
• Fever
• Abdominal pain
• Decreased appetite
• Weight loss
• Jaundice
• Swelling in the abdomen
• Increased thirst and urination

The symptoms of feline triaditis are often vague, which can make the condition hard to diagnose.⁵

Gastrointestinal symptoms

• Vomiting: Inflammation of the pancreas, liver and small intestine can cause cats to vomit.⁷
• Diarrhea: Inflammation of the small intestine can also cause bloody or watery diarrhea in cats.⁷
• Anorexia: Cats with triaditis often experience a decreased appetite and eat less than normal.⁷ Some estimates show that 63% to 97% of cats with pancreatitis (part of triaditis) experience anorexia.⁵

Liver-related symptoms

• Jaundice: Liver inflammation can lead to jaundice, which causes the skin and the whites of the eyes to take on a yellowish hue.⁷
• Increased thirst and urination: Dehydration can lead cats with triaditis to drink more water and urinate more frequently.⁷

Pancreatic symptoms

• Abdominal pain: A cat experiencing an inflamed pancreas may hide or resist being held or touched, especially in the abdominal area, due to stomach pain.⁷
• Weight loss: A lack of appetite combined with vomiting and diarrhea can cause cats with triaditis to lose weight.⁷
• Decreased activity levels, lethargy and depression are also common in cats with triaditis.⁷

Diagnosing feline triaditis

If your vet suspects your cat may have triaditis, they will perform some tests to confirm the diagnosis. The tests can include:¹

• Routine blood work: The results of a blood panel provide information about organ function. Cats with triaditis can have elevated liver enzymes, including higher-than-normal levels of alanine aminotransferase (ALT) and alkaline phosphatase (ALP).
• Specialized blood tests: Tests like a spec-fPL test and trypsin-like immunoreactivity (TLI) test that aren't part of a routine blood panel can check the blood for potentially elevated pancreatic enzymes, aiding in the diagnosis of pancreatitis.
• Urinalysis: Protein or blood in the urine could be a sign of infection that causes triaditis.
• X-rays: Radiographs detect abnormalities like an enlarged liver that are common in triaditis.
• Ultrasound: This offers an enhanced view of the intestines, pancreas and liver to check for abnormalities consistent with this disease.
• Biopsies: Collecting tissue and cells from the intestines, liver or pancreas can detect abnormalities and help rule out cancer or bacterial infections to make a more definitive diagnosis of triaditis.

Triaditis in cats: Treatment options

Your veterinarian will base treatment on which of the three diseases that make up triaditis—pancreatitis, cholangiohepatitis and inflammatory bowel disease—is most prevalent to help your cat recover.⁴

Treatment options include medication and diet changes to alleviate symptoms and reduce pain.

Medications

A combination of pain medication, antibiotics and anti-inflammatories are often prescribed to reduce inflammation, relieve pain and help control vomiting and diarrhea. Your vet may also recommend IV fluids to combat dehydration and replenish essential fluids.⁷

Dietary management

Cats with triaditis may benefit from eating a diet with moderate levels of protein and fat that is easy to digest.⁷ A canned (wet food) diet with limited ingredients may be a good option.⁴

Hospitalization and supportive care

Triaditis can cause loss of appetite, which can lead to a fatal condition called hepatic lipidosis that affects the liver. A cat that hasn't eaten may need to be hospitalized, so your veterinarian can provide appetite stimulants or use feeding tubes to provide proper nutrition.¹

Cats with triaditis can also benefit from a warm, cozy spot to rest and regular grooming to help keep them comfortable.⁷

Surgical intervention

In severe cases, cats with triaditis may need surgery to remove blockages in the biliary tract or remove a diseased section of the pancreas, liver or small intestine.⁷

Preventive care

While triaditis isn't preventable, there are steps you can take to lower the risk that your cat will develop a serious condition.¹

• Promote a healthy lifestyle: Obesity and poor diet are risk factors for triaditis.⁷ Making sure your cat eats a complete and balanced diet (without too many treats) and gets plenty of exercise to keep their weight in check can reduce their risk.
• Schedule regular vet visits: Your veterinarian can perform blood tests to monitor for changes to your cat's organ function that may allow them to diagnose and treat triaditis at the earliest stages. Vaccines to protect your cat against calicivirus, a virus that can lead to liver disease, and feline distemper, which can cause pancreatitis, can also reduce the risk of triaditis.¹
• Prevent exposure to toxins: Human medications, poisonous plants and other toxins can cause inflammation of the pancreas, liver and intestines. Keeping your cat from accessing these toxins can reduce their risk of developing triaditis.⁷

Pet insurance can support preventive care

Investing in pet insurance helps to ensure that your cat has access to the wellness care they need to stay healthy and protect them from developing chronic conditions like pancreatitis, cholangiohepatitis and inflammatory bowel disease that can lead to triaditis.

Pets Best offers cat insurance plans that can be customized for your cat's unique needs, and policyholders always have access to veterinary experts who can answer questions about triaditis or other cat health concerns through the 24/7 Pet Helpline.

Sources/Citations

1. “Triaditis in Cats," Small Door Veterinary, https://www.smalldoorvet.com/learning-center/medical/triaditis-cats#symptoms, accessed January 9, 2024.
2. "Pancreatitis and triaditis in cats: causes and treatment," K.W. Simpson (1/2015), Journal of Small Animal Practice, https://onlinelibrary.wiley.com/doi/10.1111/jsap.12313, accessed January 9, 2024.
3. “Triaditis in Cats," (11/2023), Vetster, https://vetster.com/en/conditions/cat/triaditis, accessed January 9, 2024.
4. “Triaditis in Cats: A Multi-System Syndrome," Brad Hinsperger (7/2022), Kingsdale Animal Hospital, https://www.kingsdale.com/triaditis-in-cats-a-multi-system-syndrome, accessed January 9, 2024.
5. “Feline comorbidities: What do we really know about feline triaditis?" Petra Černá, Scott Kilpatrick and Danielle A. Gunn-Moore (10/2020), Journal of Feline Medicine and Surgery, https://journals.sagepub.com/doi/10.1177/1098612X20965831, accessed January 9, 2024.
6. “Hepatic Lipidosis in Cats (Fatty Liver Syndrome in Cats)," Tammy Hunter, Catherine Barnette and Ernest Ward, VCA Animal Hospitals, https://vcahospitals.com/know-your-pet/liver-disease-fatty-liver-syndrome-in-cats, accessed January 9, 2024.
7. “Triaditis in Cats: Symptoms, Diagnosis, and Treatment," (2/2023), PetCareRx, https://www.petcarerx.com/article/triaditis-in-cats-symptoms-diagnosis-and-treatment/6526, accessed January 9, 2024.